J Korean Orthop Assoc.  2012 Apr;47(2):119-124. 10.4055/jkoa.2012.47.2.119.

Analysis of Factors That Affect the Outcome of Skin Grafts

• An KC
• Choi JS
• Kim JH
• Kim DM

• KMID: 2185387
• DOI: http://doi.org/10.4055/jkoa.2012.47.2.119

Abstract

PURPOSE
This study aimed to investigate factors that affect the successful outcome of skin grafts.
MATERIALS AND METHODS
One-hundred and one patients undergoing split-thickness skin grafts were reviewed between March 2000 and March 2008. The mean age of the patients was 39 years (16 to 67 years). The numbers of male and female patients were 63 (62.4%) and 38 (37.6%), respectively. The average follow up period was 8 weeks (2 to 23 weeks). For the analysis, patients were classified by patient factors and wound factors affecting the outcome of skin grafts. The criteria for the successful outcome of skin grafts were as follows: over 80% of skin ingestion rate, no exposure of subcutaneous tissue, no distinct signs of infection, and no need for reoperation. Also, statistical analysis was used to identify the correlation between each factor regarding the outcome of each skin graft.
RESULTS
The preoperative serum levels of c-reactive protein (CRP) and white blood cell (WBC) were significantly correlated with the success of skin grafts (p<0.05). The cut-off value of WBC and CRP were 10.500x103/microl and 1.02 mg/dl, respectively. Each factor showed 27.6 and 9.5 times of association strength.
CONCLUSION
Among the various factors, the preoperative serum levels of CRP and WBC had significant correlations regarding the successful outcome of skin grafts. This result suggests that those levels can be objective indexes to predict the outcome of skin grafts.

Keyword

skin graft; correlation factors; correlation intensity

MeSH Terms

C-Reactive Protein
Eating
Female
Follow-Up Studies
Humans
Leukocytes
Male
Reoperation
Skin
Subcutaneous Tissue
Transplants
C-Reactive Protein

Figure

• 

  Figure 1 Receiver operating characteristic (ROC) curve for prediction of skin graft outcomes. (A) ROC curve for prediction of graft failure by the level of CRP. Area under the curve was 0.760 (95% confidence interval: 0.666-0.838, p<0.001). (B) ROC curve for prediction of graft failure by the level of WBC. Area under the curve was 0.780 (95% confidence interval: 0.682-0.859, p<0.001). CRP, c-reactive protein; WBC, white blood cell.

• 

  Figure 2 Etiology of skin defects and the ratio of graft loss due to infection. In more than half of cases, the skin defects were caused by traumatic events. DM, diabetes mellitus.

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